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Arthroscopic-assisted Arthrodesis of the Knee Joint With the Ilizarov Technique

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ABSTRACT

Arthrodesis of the knee joint is a mainly a salvage surgical procedure performed in cases of infected total knee arthroplasty, tumor, failed knee arthroplasty or posttraumatic complication.

The authors report the case of 18-year-old male with posttraumatic complication of left knee because of motorbike accident 1 year before. He was treated immediately after the injury in the local Department of Orthopaedics and Traumatology. The examination in the day of admission to our department revealed deformation of the left knee, massive scar tissue adhesions to the proximal tibial bone and multidirectional instability of the knee. The plain radiographs showed complete lack of lateral compartment of the knee joint and patella. The patient complained of severe instability and pain of the knee and a consecutive loss of supporting function of his left limb. The authors decided to perform an arthroscopic-assisted fusion of the knee with Ilizarov external fixator because of massive scar tissue in the knee region and the prior knee infection.

In the final follow-up after 54 months a complete bone fusion, good functional and clinical outcome were obtained.

This case provides a significant contribution to the development and application of low-invasive techniques in large and extensive surgical procedures in orthopedics and traumatology. Moreover, in this case fixation of knee joint was crucial for providing good conditions for the regeneration of damaged peroneal nerve.

No MeSH data available.


The computed tomography AP scan of the knee before arthrodesis.
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Figure 1: The computed tomography AP scan of the knee before arthrodesis.

Mentions: A young patient aged 18 was admitted to the Department of Arthroscopy, Minimally-Invasive Surgery and Sports Traumatology 12 months after a multitissue injury of the left knee in a motorbike accident. Examination revealed an extensive lacerated wound in the knee area, a huge skin defect, type 33-B1/41-B3 fracture (according to Arbeitsgemeinschaft fur Osteosynthesfragen Foundation and American Orthopaedic Trauma Association Classification of Fractures and Dislocations—Arbeitsgemeinschaft fur Osteosynthesfragen Foundation/American Orthopaedic Trauma Association Classification of Fractures and Dislocations) of lateral femoral and tibial condyle with their amputation, comminuted fracture of the patella, an injury of the popliteal artery and veins, as well as palsy of the peroneal nerve (Figures 1 to 3). The patient was operated on in the local Department of Orthopaedics and Traumatology immediately after the accident. During the surgical procedure, the wound was thoroughly cleaned, necrotic tissues were removed, the damaged arterial and venous vessels of the limb were reconstructed and the peroneal nerve was decompressed. In the early perioperative period, an infection of the wound and skin necrosis was observed, which required further pharmacological and surgical treatment. In the early perioperative period, an infection of the wound, skin, and the other tissue necrosis was observed. The necrectomy of the affected tissue was necessary and resection of the patella was done. The multistage procedure of skin graft was needed to close and heal the wound. The multidrug antibiotic therapy was also performed.


Arthroscopic-assisted Arthrodesis of the Knee Joint With the Ilizarov Technique
The computed tomography AP scan of the knee before arthrodesis.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4998273&req=5

Figure 1: The computed tomography AP scan of the knee before arthrodesis.
Mentions: A young patient aged 18 was admitted to the Department of Arthroscopy, Minimally-Invasive Surgery and Sports Traumatology 12 months after a multitissue injury of the left knee in a motorbike accident. Examination revealed an extensive lacerated wound in the knee area, a huge skin defect, type 33-B1/41-B3 fracture (according to Arbeitsgemeinschaft fur Osteosynthesfragen Foundation and American Orthopaedic Trauma Association Classification of Fractures and Dislocations—Arbeitsgemeinschaft fur Osteosynthesfragen Foundation/American Orthopaedic Trauma Association Classification of Fractures and Dislocations) of lateral femoral and tibial condyle with their amputation, comminuted fracture of the patella, an injury of the popliteal artery and veins, as well as palsy of the peroneal nerve (Figures 1 to 3). The patient was operated on in the local Department of Orthopaedics and Traumatology immediately after the accident. During the surgical procedure, the wound was thoroughly cleaned, necrotic tissues were removed, the damaged arterial and venous vessels of the limb were reconstructed and the peroneal nerve was decompressed. In the early perioperative period, an infection of the wound and skin necrosis was observed, which required further pharmacological and surgical treatment. In the early perioperative period, an infection of the wound, skin, and the other tissue necrosis was observed. The necrectomy of the affected tissue was necessary and resection of the patella was done. The multistage procedure of skin graft was needed to close and heal the wound. The multidrug antibiotic therapy was also performed.

View Article: PubMed Central - PubMed

ABSTRACT

Arthrodesis of the knee joint is a mainly a salvage surgical procedure performed in cases of infected total knee arthroplasty, tumor, failed knee arthroplasty or posttraumatic complication.

The authors report the case of 18-year-old male with posttraumatic complication of left knee because of motorbike accident 1 year before. He was treated immediately after the injury in the local Department of Orthopaedics and Traumatology. The examination in the day of admission to our department revealed deformation of the left knee, massive scar tissue adhesions to the proximal tibial bone and multidirectional instability of the knee. The plain radiographs showed complete lack of lateral compartment of the knee joint and patella. The patient complained of severe instability and pain of the knee and a consecutive loss of supporting function of his left limb. The authors decided to perform an arthroscopic-assisted fusion of the knee with Ilizarov external fixator because of massive scar tissue in the knee region and the prior knee infection.

In the final follow-up after 54 months a complete bone fusion, good functional and clinical outcome were obtained.

This case provides a significant contribution to the development and application of low-invasive techniques in large and extensive surgical procedures in orthopedics and traumatology. Moreover, in this case fixation of knee joint was crucial for providing good conditions for the regeneration of damaged peroneal nerve.

No MeSH data available.